NPI | 1598726978 |
---|---|
Former Name | IWONA M BANGHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0000856) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C00856) |
Enumeration Date | 2006-03-28 |
Last Update Date | 2022-05-24 |